- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.00 / $2,260.00 / $6,060.00
| Facility | | $896.00 | $2,260.00 | $6,060.00 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $1,605.00 / $1,605.00 / $1,605.00
| Facility | 50 | $1,605.00 | $1,605.00 | $1,605.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $448.92 / $1,640.88 / $2,700.74
| Facility | | $448.92 | $1,640.88 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.35 / $242.04 / $2,633.00
| Facility | | $160.35 | $242.04 | $2,633.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.00 / $1,711.00 / $3,268.00
| Facility | | $1,068.00 | $1,711.00 | $3,268.00 |